4.27.07 - Issue # 268 Forward This Newsletter To A Colleague
Internal Promotion
Employee Testing
McKenzie Case Study

When Your Rising Star’s a Dud
by Sally McKenzie CEO
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Anyone who has managed employees for any length of time has seen it. The rising star with all the potential to succeed is promoted to a new position and fails. Why does it happen? How does it happen? It’s agonizing for the employee and it’s certainly no treat for the doctor either. After all, this is someone you were sure you could count on. She/he showed all the signs of being truly excellent. But, as many dentists have discovered, a promotion doesn’t guarantee that your rising star will become a superstar. Just ask Dr. Morton. 

Carolyn had been a business employee in Dr. Morton’s practice for just over a year when the office manager left and Dr. Morton promoted her to the position. Carolyn, Dr. Morton thought, would be ideal. She was bright, enthusiastic, seemed to be very good with patients, and got along great with the rest of the staff. Her title was business assistant, but her role had been more of “helper” to the previous office manager. Nonetheless, Dr. Morton felt confident that Carolyn would rise to the challenge. After all, she had indicated that she was interested in taking on more responsibility and seemed to bring some good experience to the position.

Additionally, Dr. Morton thought this would be an ideal time to implement a few administrative changes. She wanted Carolyn to take the lead in shoring up some key practice systems, including: overhead, personnel policies, cash flow, and recall for starters. Yes, indeed, Carolyn was going to be busy in her new role.

For Carolyn, this was certainly a case of “be careful what you wish for because you just might get it.” Yes, the salary was appealing. She wanted additional responsibility and the chance to tackle new challenges, but Dr. Morton didn’t mention any plans to train her in the new position. Sure, she’d been on staff long enough to understand how the office worked and Dr. Morton’s preferences, but how would she develop these policies and systems? Who would guide her? She knew she couldn’t expect Dr. Morton to answer her every question, after all it was her responsibility now. Time to sink or swim. Unfortunately, it wouldn’t be long before Carolyn felt the pinch of what would turn out to be cement shoes.

The first few months were tumultuous. Carolyn was winging it. The doctor said she wanted better management of cash flow, so Carolyn implemented a new collections policy. She was intent on proving her worth by increasing revenues immediately. The policy itself was not the problem, rather, it was the approach. Carolyn did not implement a system to inform patients in advance of the policy change. Consequently, many were surprised and a little irritated that they didn’t get at least some explanation for why the policy was changing.

What’s more, in Carolyn’s mind, a policy is a policy and it is up to the office manager to enforce it. Patients were further annoyed. Not only had the new rule been sprung on them, but the new office manager was utterly and completely inflexible in her enforcement of it. Needless to say, the phones began to ring and Dr. Morton was busy fielding calls from unhappy patients. 

Patient relations were strained and staff relations weren’t much better. Co-worker Carolyn, that nice girl who was originally hired to help out at the front desk, was now controlling Carolyn, large and in-charge and unilaterally defining personnel policies. Worse yet, she would immediately go on the defensive should someone hint that her approach could use a little softening. Her standard response was, “Well, I’m the office manager, and Doctor expects me to get these things done.” Carolyn was not holding up well under the pressure. The staff was ready to mutiny. The doctor was concerned but chalked it up to that ‘ol learning curve thing.

Over the next 12 months, staff turnover spiked and Carolyn herself eventually quit in frustration. It was a painful lesson for Dr. Morton who came to realize that just because someone is bright, energetic, enthusiastic, and seemingly competent in one position is no guarantee that they will succeed in another.

Next week, put your superstars in the best light.

Interested in speaking to Sally about your practice concerns? Email her at sallymck@mckenziemgmt.com.

Interested in having Sally speak to your dental society or study club? Click Here.

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Dr. Nancy Haller
Dentist Coach
McKenzie Management
coach@ mckenziemgmt.com
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Are You Getting the Right People on Your Bus?

Jim Collins, the author of Good to Great, found that the most successful companies are known for "getting the right people on the bus, the wrong people off the bus and the right people in the right seats”.

He is referring to the importance of smart hiring and training for business success. The “right people” are those individuals who fit into your practice and help you to accomplish your future goals.

Determining who will be a good employee and fit into your practice is an enormous challenge. Hiring accuracy is reduced further by the fact that most dental offices use only interviews, a resume, and an application to make a decision that will have a HUGE impact on productivity and revenue.

Consider the statistics: a “bad hire” is estimated to cost you between 30% and 150% of an employee’s annual salary!!

Getting the “right people” onto your bus starts before you place a job ad. You need job descriptions. When developing job descriptions, first think about what skills and experience a candidate will need today and in the future, then, identify those critical components that are not trainable.

But even if a candidate meets those requirements, the “right people” also need predictable behaviors. They need to be conscientious, stress-resistant, and cooperative. These characteristics are referred to as personality. To get the right people on the bus, you must correctly define the personality of the job, and then evaluate applicants according to the total job personality. This is the only way to maximize a good fit. McKenzie Management has done that for you.

We conducted personality-based job analyses for four dental positions - Dentist, Front Office, Hygienist, and Clinical Assistant. First we identified experts in the dental field who have direct and current experience with each job, its duties, responsibilities, and requirements for successful performance. These ‘subject matter experts’ then completed work style surveys for each of the four positions. The surveys consisted of questions about the requirements for effective performance using a rating scale of Unhelpful, Not Required, Helpful, or Essential.

The end result is the Employee Assessment Test  By having the candidate/employee answer 107 questions on-line, you can tell  how close your candidate matches peak performers in their job description.

If you rely on traditional interviews be aware that they are subjective. Interviews measure social skills, not job suitability. Individuals who create a positive impression are viewed as more capable than quiet or nervous applicants. Because they are not objective, interviews are the least accurate predictors of job success.

Perhaps you rely on resumes and believe that this improves your hiring accuracy. However, the U.S. Department of Labor estimates that 90% of all resumes contain false information!

You may rely on reference checks, convinced that talking with previous employers will give you useful insights. Forget it. Former employers generally reveal nothing of significance. In fact, in many states it is illegal to give any information except for dates of employment.

With the cost of hiring the “wrong” person rising, you owe it to yourself to find a better way to hire employees. The solution is to match the applicant’s personality to the job.

Studies show that employment testing outperforms traditional interviews 4 to 1 in predicting job performance. As a complement to your selection process, testing is a proven, effective method of getting the right people on your bus. The Employee Assessment Test strictly adheres to legal guidelines for pre-employment testing and is available only through McKenzie Management.

Every dentist wants employees who are happy in their jobs with great attitudes. When employees like their jobs, they'll do a better job. Having the RIGHT PERSON in the RIGHT JOB is absolutely key to profitability.

Next article: Keeping the right people on your bus: Maximizing retention.

Dr. Haller’s Upcoming Speaking Engagements
California Dental Association in Anaheim on May 3, 2007
Connecticut State Dental Association on May 11, 2007

Dr. Haller can help you to get your practice from good to great.
Contact her at coach@mckenziemgmt.com.

Interested in having Dr. Haller speak to your dental society or study club? Click Here.

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Nancy Caudill
Senior Consultant
McKenzie Management
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Quantity or Quality?

A McKenzie Management Case Study

Dr. Jerry Marks – Case Study #222

“I need more new patients!”, said  Dr. Marks who called McKenzie Management to see if he could “order” an additional 20 new patients per month.  We sure wish that we could fill such a request.  However, we do teach doctors and staff how to determine the number of new patients they really need.

Like many things in business, “more” is not always better.  Sometimes it is “quality” and not “quantity”.  Dr. Marks is a good example of this.

Practice statistics:

  • Practice 3 years old
  • Built the practice with Medicaid, PPOs and HMOs
  • Practice was seeing about 100 “new” patients per month
  • The doctor was spending almost 10% of his monthly net collections on marketing
  • Even though Fee Schedules were being posted that already illustrated a reduced production compared to the practice’s UCR fee, an additional 10% of gross production was still being written off.
  • 1 additional staff person was employed to manage the HMO and Medicaid pre-treatment estimates and claims

First, let’s determine the definition of “new patient”.  McKenzie Management’s definition of a new patient is someone that has been seen for a professional cleaning or perio maintenance appointment for the first time in the office.  Usually, this also means a patient that has been seen for a comprehensive exam, by the doctor, and then examined by the hygienist and placed into the recall system.  There are a few exceptions but we will use this definition for this example.

The reason for using this definition, opposed to any new patient, such as an emergency extraction, is that patients that go into the hygiene recall program contribute to the growth of the practice and patients that are seen only periodically for emergency treatment do not.  If you recall from previous articles, your practice grows by increasing the number of hygiene days, NOT by increasing the number of “new” patients that are seen.

Additional practice statistics relative to the practice growth:

  • Dr. Marks’ practice only had a 50% retention rate.
  • The number of new “hygiene” patients was only 50-60 patients per month.  The rest of his “new” patients were emergency only or were seen for restorative procedures, but never seen for professional cleanings or periodontal treatment and subsequent perio maintenance appointments.
  • After 3 months, he added a hygienist for 3 days a week and never increased his hygiene days over the past 3 years.

This information told me that even though he was seeing 100 “new” patients a month, the practice was not growing!  See, for those of you who thought you would be thrilled with 100 new patients a month, this means nothing relative to practice growth.  Why?  It is all about “quality and not quantity”.

After spending the first two days with Dr. Marks, we discussed his practice strategies and philosophy. 

New practice recommendations:

  • Consider not participating in state-funded programs
  • Consider not participating in HMO’s
  • Reduce the number of PPOs he participated in slowly and methodically
  • Improve his internal marketing
  • Seek professional assistance for external marketing
  • Create a practice identity and brand it
  • Set a new goal of 25 new Comprehensive Exam patients per month
  • Improve his patient retention to 90%
  • Increase the number of hygiene days as a result of improved retention

It may appear that these goals are unrealistic, but when I returned to his office less than 12 months later, he had achieved all of these and was reducing his PPO participation.

Now you are asking ….”How much money did he lose going through these changes?”  As these changes took place, there were also indirect changes that took place, such as a reduced number of staff, shorter office hours (no weekends and evenings), more customer service, and much less stress!

He also added an additional 2.5 days of hygiene per week and took more vacation time.  I would call this working “smarter and not harder”, wouldn’t you?  Let’s look at the following:

New practice statistics:

  • 6 days of hygiene per week.  This results in “passive net income” for Dr. Marks of almost $100,000 a year, not including 50% of his restorative production that comes from seeing his hygiene patients for their periodic exams.
  • Averaging 26 new “comprehensive” patients a month that are either participating in one of only 3 PPO plans which he still chooses to participate with or the patients accept his UCR fees.  (He still accepts the assignment of benefits as a courtesy to his patients but only participates in 3 PPOs).
  • His monthly “net” collections are only down about 10% because of the following:
    • Each patient accepts more treatment
    • Hygiene production has been increased
    • Overhead has been reduced

Dr. Marks is on schedule to net produce and collect more over the next 12 months than he did over the past 24 months on average.  By applying McKenzie Management’s business systems and maintaining his awareness of how his practice is performing by reviewing monthly statistics, the day-to-day activities of the practice are not a concern anymore.  Dr. Marks has learned how to “keep his finger on the pulse of the practice” as well as make sense of his monthly P&L that he receives from his accountant to determine if his overhead goals are being met.

Now…..I ask you.  What is more important?  Quantity or Quality?  Dr. Marks will tell you that 100 “new” patients a month did not get him where he is now or where he will be next year.  But, the 25 new “comprehensive” patients a month will!

If you would like more information on how McKenzie's Practice Enrichment Programs can help you IMPLEMENT proven strategies….. email info@mckenziemgmt.com.

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